Pathophysiology

Front 1

CHD is characterized by

Back 1

insufficient delivery of oxygenated blood to the myocardium due to atherosclerotic coronary arteries (CADs)

Front 2

Sequelae of CHD include:

Back 2

Angina pectoris
› Myocardial infarction
› Dysrhythmias

› Heart failure
› Sudden cardiac death

Front 3

Atherosclerosis causes:

Back 3

narrowing of the

arterial lumen that can lead to cardiac

ischemia through:
› Thrombus formation
› Coronary vasospasm
› Endothelial cell dysfunction

Front 4

Mechanisms of Coronary Atherosclerosis

Lipids are transported via

Back 4

apoproteins

Front 5

Mechanisms of Coronary Atherosclerosis

High-density lipoproteins transport cholesterol from _______ __________ back to ______, ___________

Back 5

from peripheral tissue

back to the liver, clearing atheromatous plaque

Front 6

Mechanisms of Coronary Atherosclerosis

Atherosclerotic plaque formation initiated by

Back 6

injury to coronary artery endothelium

Front 7

Mechanisms of Coronary Atherosclerosis

What becomes permeable and recruits leukocytes?

Back 7

Endothelium

Front 8

Mechanisms of Coronary Atherosclerosis

LDL insudation occurs with oxidation by

Back 8

endothelial cells and macrophages

Front 9

Mechanisms of Coronary Atherosclerosis

Oxidized lipids are damaging to what?

Stimulate recruitment from what?

Back 9

endothelial and smooth muscle cells,

stimulate recruitment of macrophages into the vessel

Front 10

Mechanisms of Coronary Atherosclerosis

Macrophages engulf what? This stimulates what?

Back 10

Lipids.

foam cells release inflammatory mediators and growth factors, attracting more leukocytes and stimulate smooth muscle proliferation

Front 11

Mechanisms of Coronary Atherosclerosis

Excess lipid and debris accumulate within vessel wall and causes what?

Back 11

coalesce into lipid core

Front 12

Mechanisms of Coronary Atherosclerosis

Vulnerable plaques may rupture or become eroded, which stimulates what?

Back 12

clot formation on the plaque

Front 13

Mechanisms of Coronary Atherosclerosis

Vulnerable plaques have:

Back 13

› Large lipid core
› Thin cap
› High shear stress

Front 14

Pathophysiology of Ischemia

Ischemia occurs when....

Back 14

oxygen supply is insufficient to meet metabolic demands

Front 15

Pathophysiology of Ischemia

Coronary perfusion can be altered by:

Back 15

› Large, stable atherosclerotic plaque
› Acute platelet aggregation and thrombosis

› Vasospasm

› Failure of autoregulation by the microcirculation

› Poor perfusion pressure

Front 16

Clinical Features and Management of Coronary Syndromes

Chronic syndromes with slow progression

due to what?

Back 16

chronic obstruction from stable

atherosclerotic plaques:

› Stable angina pectoris
› Ischemic cardiomyopathy

Front 17

Clinical Features and Management of Coronary Syndromes

Acute coronary syndrome (ACS) associated with what?

Back 17

acute changes in plaque morphology and

thrombosis:
› Unstable angina
› Myocardial infarction

Front 18

Angina Pectoris

chest pain associated with:

Back 18

intermittent myocardial ischemia

Front 19

Angina Pectoris

May result in:

Back 19

inefficient cardiac pumping with resultant pulmonary congestion and shortness of breath

Front 20

Angina Pectoris

Three patterns of angina pectoris:

Back 20

› Stable
› Prinzmetal
› Unstable

Front 21

Acute Coronary Syndrome

Plaque rupture with what?

Back 21

Acute thrombus development

Front 22

Acute Coronary Syndrome

Unstable angina=

MI=

ECG and biomarkers are used for what?

Back 22

Occlusion is partial

occlusion is complete

For a diagnosis

Front 23

Acute Coronary Syndrome

How long does chest pain last?

Back 23

Chest pain usually more severe and lasts longer than typical angina

Front 24

Acute Coronary Syndrome

MI leads to a drop in what? triggering activation of what?

Back 24

Drop in CO

Trigger Sympathetic activation

Front 25

Acute Coronary Syndrome

Sympathetic NS activation leads to what?

Back 25

Increased myocardial workload by increasing:

Heart rate

contractility

blood pressure

Front 26

Sudden Cardiac Death

what should be used when someone has experienced SCD?

Back 26

Use of external defibrillators and CPR has increased survival

Front 27

Sudden Cardiac Death

What lethal dysrhythmia is the primary cause of SCD?

Back 27

Ventricular fibrillation

Front 28

Chronic Ischemic Cardiomyopathy

Heart failure develops insidiously due to:

Back 28

progressive ischemic myocardial damage

Front 29

Chronic Ischemic Cardiomyopathy

Typically have history of what?

Back 29

Angina or MI

Front 30

Chronic Ischemic Cardiomyopathy is most common in:

Back 30

older adults